Occupational therapists can help clients of all ages with mealtime participation by providing strategies and interventions to improve function. This includes addressing physical and sensory limitations, improving utensil skills, and creating strategies for optimal feeding behaviors.
For example, occupational therapists can help a child find an appropriate utensil or new foods they enjoy. OTs can also coach parents on how to safely introduce new foods to a child to encourage a lifelong habit of healthy, happy eating patterns.
Occupational therapists can also provide adaptive equipment (e.g., modified utensils, specialized seating) to make eating easier.
Most importantly, occupational therapists provide education and support to parents, family members, and loved ones to help them better understand each client’s feeding needs.
Feeding Development
Feeding is an essential part of any child's development and is related to their overall readiness in terms of physical, mental, and emotional development. The process is multisensorial, multifactorial, and multidimensional and involves the integration of various systems within the body. It is also context-dependent on experience with taste, health status, cultural factors, and socioeconomic status.
While there is a basic timeline for feeding development, it should be seen as a guide rather than a strict rule.
Feeding Milestones
Newborn
- Food/liquid intake: Exclusively accepts breast milk and/or formula
- Motor skills: Strong gag, root, and phasic bite-releasesuckles/sucks when the hand comes to the mouth, sucks liquid from bottle and/or breast
1-2 months
- Food/liquid intake: Exclusively accepts breast milk and/or formula
- Motor skills: Sucks liquid from bottle and/or breast, semi-reclined posture during feeding
2-3 months
- Food/liquid intake: Exclusively accepts breast milk and/or formula
- Motor skills: Sucks liquid from bottle and/or breast, gazes with caregiver during feeding
3-4 months
- Food/liquid intake: May begin puree and cereal with breast milk and/or formula
- Motor skills: Begins to place their hands on the bottle when feeding
5-6 months
- Food/liquid intake: May begin puree and cereal with breast milk and/or formula; may begin lumpy solids if they began to eat puree earlier
- Motor skills: Spoon feeding and cup drinking introduced, holds own bottle with both hands
6-9 months
- Food/liquid intake: Breast milk and/or formula, lumpy solids with improved ability to manage harder lumps, finger foods begin (pieces of cereal, teething crackers, pieces of cooked pasta)
- Motor skills: Lip closure on a spoon, more upright posture, lateral tongue movement, munching patterns, attempts to help with feeding
9-12 months
- Food/liquid intake: Finger feeding, easily managing bite-sized solids (e.g., fruits and vegetables), breast milk, and/or formula
- Motor skill: Drinks from a cup held by a caregiver, accepts greater textures and variety, rotary chewing, reaches for spoon
12-18 months
- Food/liquid intake: Whole milk, dairy, fruit, cooked veggies, small pieces of meat and protein, juice
- Motor skills: Grasps spoon with whole hand, holds and drinks from a cup with two hands, holds and tips bottle, grasps spoon with both hands, holds drink from a cup with both hands, holds bottle independently
18-24 months
- Food/liquid Intake: Whole milk, dairy, fruit, cooked veggies, small pieces of meat and protein, juice
- Motor skills: Primarily self-feeds, chews, and swallows a wide range of textures; oral movements are more efficient
24-36 months
- Food/liquid intake: Wide range of solid foods, low-fat milk, dairy, fruits, meat, combo foods, fruits and/or vegetables, juice
- Motor skills: Holds cups w/one hand, uses open cup without spilling, places food on a spoon with fingers, uses fork to poke food
References and Resources
What is Typical Feeding Development? OccupationalTherapy.com course by Rhonda Mattingly Williams, EdD, CCC-SLP.
